Writing Homework Help

I’m trying to study for my Writing course and I need some help to understand this question.

Working for a small private practice group that transitioned to electronic medical record within the last year would be a challenge to determine quality incentives regarding diabetes mellitus.  With the implementation of electronic records obtaining data would be easy.  Unfortunately, the previous years of paper charting would be very cumbersome and would not yield a benefit going back unless needed.  With a thousand charts to go through this would be very time consuming for a small practice and would not be a viable option.

Once you determine what metrics you would like to evaluate you can start by establishing how many patients are diagnosed with diabetes mellitus.  Once you have this established you could focus more on the components within the quality incentive programs.  One of the programs used by the Centers for Medicare/Medicaid Services is the HEDIS or Healthcare Effectiveness Data and Information Set (HEDIS) comprehensive care measures.  HEDIS is a comprehensive set of standardized performance measures designed to provide purchasers and consumers with the information they need for a reliable comparison of health plan performance (CMS, 2021).  With this HEDIS tool the practice could effectively evaluate previous patient data to focus on which patients currently meet all the components and which patients needs further evaluation and treatment.  The first step in establishing a comprehensive diabetes care would be to check a hemoglobin a1c.  After this has been obtained you establish either poor control or under control with a hemoglobin a1c of greater than 9.0 as poor and lower than 8.0 as under control.  Another aspect of the guidelines is to check for retinal eye disease with an eye exam.  Further risk reduction is needed due to the complexity of the disease process by checking renal function to determine progression of nephropathy due to diabetes.  The last criteria are to maintain blood pressure readings less than 140/90 (NCQA, 2021).

Once you establish the number of patients within the practice that would meet criteria the biggest promotion the practice could do is establish set protocols for every patient that would meet criteria.  This would move the practice in a positive direction to obtain performance metrics that would lead to quality incentives from CMS and third-party payers.  Education for the patients would also be vital to improve performance as some patients may not be in control and have other compliance issues related to blood pressure management and obtaining lab work in a timely fashion.